Bruce D Larson, PAC

NPI #1265470371 in Lisbon, North Dakota

Provider Information

NPI Number: 1265470371
Entity Type: Individual
Name: Bruce D Larson, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Jun 2, 2006
Last Updated: Feb 19, 2016

Practice Location

Address: 819 MAIN ST
City: Lisbon
State: North Dakota
ZIP Code: 58054-4244
Phone: (701) 683-4134

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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